A device and method for acquiring tissue in preparation for tissue fastening includes an acquisition head having a pair of vacuum chambers. A vacuum source is used to draw a tissue into a first one of the chambers, and a grasper is extended into the chamber to engage the tissue, allowing vacuum pressure to be released without loss of the tissue from the chamber. Tissue is subsequently drawn into an adjacent chamber and then similarly engaged in the chamber using a second grasper. The two or more sections of acquired tissue may be held in complete or partial alignment with one another as staples or other fasteners are driven through the pinches, thus forming a four-layer tissue plication.
